{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T18:33:14Z","timestamp":1789065194953,"version":"build-2803163510"},"reference-count":17,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2017,1,1]],"date-time":"2017-01-01T00:00:00Z","timestamp":1483228800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Clin Med Insights Ear Nose Throat"],"published-print":{"date-parts":[[2017,1,1]]},"abstract":"<jats:p> Thyroid storm is a rare, potentially lethal condition involving collapse of the hypothalamic-pituitary-thyroid feedback loop. Thyroid storm carries a significant mortality rate, thus requiring prompt identification and treatment. A 47-year-old woman presented to the emergency department complaining of palpitations, shortness of breath, and emesis for 24\u2009hours after using methamphetamine. Past medical history was significant for untreated hyperthyroidism. Physical examination revealed a prominent, palpable thyroid. The Burch-Wartofsky-Score was 35. Management for thyroid storm included propylthiouracil (PTU), super saturated potassium iodide, intravenous hydrocortisone, and propranolol. However, a rare drug reaction to PTU on day 3 resulted in agranulocytosis. Propylthiouracil was withheld and a modified total thyroidectomy performed on day 8 without complications and the patient discharged on day 10 with levothyroxine. Undertreated hyperthyroidism may predispose patients to catecholamine-induced thyrotoxicosis due to catecholamine hypersensitivity. With known methamphetamine use, methamphetamine toxicity and a methamphetamine-exacerbated thyroid storm need to be included in the differential diagnosis in a patient presenting with signs of thyrotoxicosis. In addition, treating patients with agranulocytosis from PTU with a modified total thyroidectomy using ligation of the vascular supply as the initial surgical step limits release of thyroid hormone into the blood stream during thyroidectomy and decreases the possibility of intra operative thyroid storm. <\/jats:p>","DOI":"10.1177\/1179550617741293","type":"journal-article","created":{"date-parts":[[2017,11,17]],"date-time":"2017-11-17T11:49:49Z","timestamp":1510919389000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":7,"title":["Methamphetamine Use With Subsequent Thyrotoxicosis\/Thyroid Storm, Agranulocytosis, and Modified Total Thyroidectomy: A Case Report"],"prefix":"10.1177","volume":"10","author":[{"given":"Omar","family":"Viswanath","sequence":"first","affiliation":[{"name":"Department of Anesthesia, Critical Care, and Pain Medicine, Beth Israel Deaconess Medical Center, Boston, MA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Deanna C","family":"Menapace","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology, Mayo Clinic, Rochester, MN, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Don B","family":"Headley","sequence":"additional","affiliation":[{"name":"Division of Otolaryngology, Department of Surgery, St. Joseph\u2019s Medical Hospital and Medical Center, Phoenix, AZ, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2017,11,17]]},"reference":[{"key":"bibr1-1179550617741293","doi-asserted-by":"publisher","DOI":"10.1089\/thy.2011.0334"},{"key":"bibr2-1179550617741293","first-page":"663","volume":"5","author":"Bindu N","year":"2006","journal-title":"Endocrinol Metab Clin North Am"},{"key":"bibr3-1179550617741293","doi-asserted-by":"publisher","DOI":"10.1016\/S0889-8529(18)30165-8"},{"key":"bibr4-1179550617741293","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-93-5-694"},{"key":"bibr5-1179550617741293","volume-title":"Results from the 2009 National Survey on Drug Use and Health: Volume I. Summary of National Findings (Office of Applied Studies, NSDUH Series H-38A, HHS Publication No. SMA 10-4586 Findings)","author":"Substance Abuse and Mental Health Services Administration","year":"2010"},{"key":"bibr6-1179550617741293","volume-title":"Harrison\u2019s Principles of Internal Medicine","author":"Mello NK","year":"2012","edition":"18"},{"key":"bibr7-1179550617741293","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-93-5-707"},{"key":"bibr8-1179550617741293","doi-asserted-by":"publisher","DOI":"10.1002\/hup.2335"},{"key":"bibr9-1179550617741293","doi-asserted-by":"publisher","DOI":"10.1080\/08964289.1994.9934622"},{"key":"bibr10-1179550617741293","doi-asserted-by":"publisher","DOI":"10.1089\/thy.2010.0417"},{"key":"bibr11-1179550617741293","doi-asserted-by":"publisher","DOI":"10.1097\/00019616-199911000-00008"},{"key":"bibr12-1179550617741293","doi-asserted-by":"publisher","DOI":"10.1507\/endocrj.49.29"},{"key":"bibr13-1179550617741293","doi-asserted-by":"publisher","DOI":"10.1089\/thy.2013.0476"},{"key":"bibr14-1179550617741293","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2141.1986.tb04130.x"},{"key":"bibr15-1179550617741293","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2007-0229"},{"key":"bibr16-1179550617741293","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2265.1991.tb03562.x"},{"key":"bibr17-1179550617741293","author":"Cummings CW","year":"1986","journal-title":"Mosby"}],"container-title":["Clinical Medicine Insights: Ear, Nose and Throat"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/1179550617741293","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/1179550617741293","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/1179550617741293","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,10,16]],"date-time":"2024-10-16T02:35:57Z","timestamp":1729046157000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/1179550617741293"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2017,1,1]]},"references-count":17,"alternative-id":["10.1177\/1179550617741293"],"URL":"https:\/\/doi.org\/10.1177\/1179550617741293","relation":{},"ISSN":["1179-5506","1179-5506"],"issn-type":[{"value":"1179-5506","type":"print"},{"value":"1179-5506","type":"electronic"}],"subject":[],"published":{"date-parts":[[2017,1,1]]},"article-number":"1179550617741293"}}